Head, Neck, Lymphatics, Face, Parotid Gland, Temporal,

Front 1

Describe L. Lyphatic Duct

Back 1

larger & longer than others; drains from other 6 lymph trunks

Front 2

Lymphatic Trunk

Back 2

9 lymphatic trunks:
-L and R lumbar
-intestinal
- L & R subclavian
- L & R bronchomediastinal lymph trunks
-L & R jugular

Front 3

L & R jugular lymph trunks drain?

Back 3

lymph from head & neck to thoracic duct & right lymph duct

Front 4

Lymphatic Ducts

Back 4

2; RIGHT LYMPHATIC DUCT drains lymph from upper right side of bidy (r. bronchomediastinal, r. subclavian & r. jugular lymphatic trunks empty here) L. lymph duct from all other trunks

Front 5

Where do L. Lymphatic (thoracic) and R. Lymphatic Ducts empty into?

Back 5

L.: Left Venous Angle
R.: Right Venous Angle

Front 6

Pathway of Lymph Flow

Back 6

Capillaries--> Lymphatic Vessels--> Remote/Local Lymph Nodes--> Lymphatic Trunks--> Lymphatic Ducts--> R/L Venous Angle--> Rejoin venous system, at root of neck

Front 7

Lymph node

Back 7

small masses of lymph tissue; act as filtering mechanisms for lymph, produce lymphocytes & antibodies

Front 8

Divisions of Lymph vessesls/explain

Back 8

Superficial/Deep
Superficial: in superficial fascia, superficial drain intot the deep lypmh vessels, which accompany major deep veins

Front 9

Factors involved in movement of lymph

Back 9

1) filtration pressure in tissue space, generated by filtration of fluid from blood capilaries
2) contraction of surrounding muscles
3) pulsation from nearby arteries compressing lymph cap.
4) respiratory movements
5) sm. muscle in walls of lymph trunks

Front 10

Lymphangitis & lymphadenitis

Back 10

lymph vessels becoming inflamed due bacterial infection; superficial lymph vessel may get painful reddish streak beneath skin & nodes become greatly enlarged--> lymphandenitis

Front 11

Pericervical Ring: receives drainage from? made up of?drains to?

Back 11

Draingage from sup. face & scalp;
From post--> ant.:
1) occipital nodes
2) retroauricular nodes
3) parotid nodes
4) buccal nodes
5) submandibular nodes
6) submental nodes
drain into deep cervical nodes, except: buccal & some mental that drain to submandibular nodes

Front 12

Describe Vertical Cervical Lymph Nodes (Chains)

Back 12

superficial cervical lymph nodes lay on ex. jugular v; deep cervical lymph nodes along int. jugular vein, from base of skull down to root of neck

Front 13

2 named & important Vertical Cervical Lymph nodes:

Back 13

1) jugulo-digastric
2) juguloomohyoid

Front 14

Jugulodigastric node

Back 14

superior deep grp; palatine tonsil & nasopharynx drainage

Front 15

inferior deep grp of vert. cerv. lymph nodes

Back 15

found along lower jugular vein & subclavian veins; includes jugulooomohyoid; drains tongue

Front 16

Supraclavicular/Sentinel Nodes

Back 16

receive drainage from vast majority of body; sit in final common pathway of lymph drainage from entrie body; important for cancer

Front 17

Lymph Drainage of Tongue

Back 17

Anterior 2/3: submental nodes, submandibular nodes,can also bypass pericervical and drain directly into deep cervical
Post 1/3:Deep cervical
Drainage from center can be bilateral, esp at tongue tip; makes cancer spread hard to stop (can involve whole neck)

Front 18

Lymph drainage of teeth

Back 18

Maxillary: buccal nodes
Mandibular: posteriorly thru mandibular canal to deep cervical chain

Front 19

Lymph drainage of Nasal cavity, sinuses & nasopharynx

Back 19

--ant. nasal cavity--> submandibular nodes
--post. nasal cavity, sinuses & nasopharynx--> directly to dep cervical chain OR via parotid nodes, retropharyngealnodes to deep cervical

Front 20

Lymph drainage of pharynx & esophagus

Back 20

--thru retropharyngeal nodes, paratracheal nodes or directly to deep cervical chain

Front 21

Lymph drainage of larynx & trachea

Back 21

lymphatics of larynx above vocal folds--> deep cervical chain
Below--> thru pretracheal & paratracheal nodes OR directly to deep cervical chain

Front 22

Lymph drainage of pharynx & esophagus

Back 22

thru retropharyngeal nodes, paratracheal nodes, OR direct into deep cerivcal chainj

Front 23

Lymphatic drainage of Larynx & trachea

Back 23

lymphatics of larynx above vocal folds drain directly to deep cervical chain; larynx below vocal folds drain thru pretracheal & paratracheal nodes OR diirect into cervical chain

Front 24

Jugulodigastric drains?

Back 24

superior deep group; palatine tonsil & nasopharynx

Front 25

Facial Artery: branch off what? has what branches?

Back 25

External Carotid artery;
o Submental artery
o Inferior labial artery
o Superior labial artery
o Lateral nasal artery
o Tonsillar arteries

Front 26

Maxillary Artery: branch off what? has what branches?

Back 26

External Carotid Artery;
o Three parts: Mandibular, Pterygoid and Sphenopalatine
 Mandibular part
• Medial side of mandible
• Branches
o Middle meningeal artery
o Inferior alveolar artery
o Anterior tympanic artery
o Deep auricular artery
 Pterygoid part
• Crosses lateral pterygoid muscle
• Branches
o Deep temporal arteries
o Masseter artery
o Pterygoid artery
o Buccal artery
 Sphenopalatine part
• Medial to lateral pterygoid muscle
• Terminal branches of maxillary artery
• Posterior superior alveolar artery
o Pterygopalatine fossa → pterygomaxillary fissure → infratemporal fossa → posterior superior alveolar foramen → posterior maxillary teeth

Front 27

Describe Ptergoid part of maxillary atery

Back 27

• Crosses lateral pterygoid muscle
• Branches: 4
o Deep temporal arteries
o Masseter artery
o Pterygoid artery
o Buccal artery

Front 28

Describe Mandibular part of maxillary atery

Back 28

•Located on Medial side of mandible
• Branches: 4
o Middle meningeal artery
o Inferior alveolar artery
o Anterior tympanic artery
o Deep auricular artery

Front 29

Describe Sphenopalatine part of maxillary atery

Back 29

• Medial to lateral pterygoid muscle
• Terminal branches of maxillary artery (2)
• Posterior superior alveolar artery
o Pterygopalatine fossa → pterygomaxillary fissure → infratemporal fossa → posterior superior alveolar foramen → posterior maxillary teeth
• Infraorbital artery
o Pterygopalatine fossa → infraorbital fissure → infraorbital groove → infraorbital canal → infraorbital foramen → face

Front 30

Describe Parotid Gland

Back 30

• Over masseter muscle
• Posteriorly to external ear
• Superiorly to zygomatic arch
• Overlaps SCM
• Associated with
o Facial nerve
• Runs thru it, emerges as 5 motor branches
o Auriculotemporal nerve
• Enters after passing neck of condyle
o Great auricular nerve
o External carotid artery
• Enters parotid
• Gives off terminal branches
• Superficial temporal artery
• Maxillary artery
o Retromandibular vein
• Pass thru parotid
o Parotid lymph nodes located on parotid sheath and within the gland

Front 31

Identify 3 main neuromuscular strucutres that transverse the parotid gland

Back 31

From superficial to deep, the structures traversing the gland are arranged: facial nerve and its branches, retromandibular vein, and external carotid artery. Retromandibular vein is formed by the union of the superficial temporal and maxillary veins. It divides into anterior and posterior divisions and drains the sides of the head, scalp, and deep face.

Front 32

Bell's Palsy

Back 32

a condition that involves the facial nerve (VII cranial nerve) and results in the paralysis of one side of the face. Bell's (facial nerve palsy) can be differentiated from a central (stroke) deficit by the inability to raise the eyebrow on the affected side.

Front 33

Trigeminal neuralagia/tic douloureux

Back 33

a disorder of trigeminal nerve (cranial nerve V) dysfunction. Synonym: tic douloureux. Characterized by excruciating paroxysms of pain in the lips, gums, cheek or chin, and, very rarely, in the distribution of the eye (ophthalmic division of the trigeminal nerve).

Front 34

Frey's Syndrome

Back 34

a condition in which the parasympathetic nerves (branches in the auriculotemporal) which normally supply the parotid gland innervate the sweat glands in the area, leading to sweating over the parotid when eating

Front 35

Parotid Calcus

Back 35

A stone in the parotid duct

Front 36

Sialogram

Back 36

an X-ray study of the salivary ducts. A contrast material is injected into the salivary duct (within the mouth) to highlight the course and caliber of the ducts. This test is used to detect a stricture or blockage (for example stones, tumor) of the salivary ducts.

Front 37

Sialothiasis

Back 37

Formation of a stone in a duct of a salivary gland (parotid calculus)

Front 38

Mumps

Back 38

an infectious acute viral disease affecting the parotid glands. The gonads, meninges and pancreas can also be affected. The causative agent is a paramyxovirus. Humans are the only natural host for this disease. Common symptoms include weakness, fever, sore throat, malaise and puffiness to the cheeks (due to parotid gland swelling). Patients are contagious 1 day prior to the onset of swelling until the swelling is gone. Recovery is generally in 2 weeks.

Front 39

depressor anguli oris

Back 39

Action: pulls the corner of the mouth downward, a frown muscle
Innervation: marginal mandibular & buccal branches of facial nerve (VII)

Front 40

zygomaticus major

Back 40

Elevates & draws corner of mouth laterally; a smile muscle; innervated by zygomatic & buccal br of facial nerve (CNVII)

Front 41

Levator Labii Superioris

Back 41

Elevates upper lip; buccal branch o f facial nerve (CNVII)

Front 42

Orbicularis Oris

Back 42

Purses lips; buccal br of facial nerce (VII)

Front 43

Buccinator

Back 43

pulls corner of mouth laterally; pulls cheek against teeth; innervated by buccal br of CN VII(NOT buccal nerve!!!!)

Front 44

Platysma

Back 44

draws corners of mouth down; aids in depression of mandible; innervated by facial nerve, cervical br

Front 45

cutaneous innervation of face is described by 3 dermatomes--name

Back 45

Trigeminal (CNV) V1, V2, V3
V1: Opthalmic Nerve
V2:
V3:

Front 46

Provides cutaneous innervation to skin and scalp superior to eye. Has 2 branches--name

Back 46

Frontal Nerve of CN V, V1 (Ophthalmic nerve of Trigeminal)
Branches: Supratrpochlear, Supraorbital

Front 47

Provides cutaneous innervation to corner of orbit & superior lid

Back 47

Palpebral br of lacrimal nerve of Ophthalmic Nerve of Trigeminal(CV, V1)

Front 48

Innervates medial aspect of eye & proximal nose

Back 48

The Infratrochlear br of the Ophthalmic Nerve of Trigeminal Nerve (CV, V1)

Front 49

Innervates the Distal Nose

Back 49

The external nasal br of the anterior ethmoidal nerve of Ophthalmic Nerve of Trigeminal(CV, V1)

Front 50

Branches of Ophthalmic Nerve of Trigeminal Nerve (CV, V1)

Back 50

Frontal, Palpebral, Lacrimal, Infratrochlear, External nasal br of Anterior Ethmoidal Nerve

Front 51

If the cutaneous innervations of face AREN'T supplied by CN VII & V face they are supplied by

Back 51

the cervical spinal nerves

Front 52

Describe Herpes Zoster Opthalmicus

Back 52

AKA-shingles; a viral infection of face supplied by ophthalmic nerve (CV, V1) cornea often involved; spread of infection within orbit to CNs III, IV & VI may lead to partial paralysis of associated muscles

Front 53

Intermediate subdivision of CNV (Trigeminal)and branches

Back 53

The Maxillary nerve (CNV2); cutaneous innervation of face via infraorbital and zygomatic nerves

Front 54

(CNV2) branch of Maxillary Nerve of Trigeminal N; skin inferior to eye, lower lid, lateral portion of nose

Back 54

Infraorbital nerve; branch of? innervates?

Front 55

Zygomatic nerve: branch of? Own branches? Branches innervate what?

Back 55

Branch of Maxillary Nerve of Trigeminal (CNV2; zygomatic branches are:
1) Zygomaticofacial: innervates skin lateral to eye
2) Zygomaticotemporal: innervates skin superior & lateral to eye

Front 56

Local anesthesia of middle of face done by? Care must be taken to prevent?

Back 56

local anesthetic infilatration of the infraorbital nerve in infraorbital foramen; foramen localized by pressure on maxilla that causes acute pain; care to prevent injection of anesthetic into infraorbital artery or vein

Front 57

What is CNV3? Branches?

Back 57

Mandibular Nerve, inferior subdivision of CN V (Trigeminal) Branches:
auriculotemporal, mental & buccal provide cutaneous innervation to face

Front 58

Auriculotemporal nerve: branch from? Innervates what?

Back 58

From Mandibular nerve, of Trigeminal (CN V3); cutaneous innervation to skin & scalp immediately anterior to ear

Front 59

Mental Nerve:branch from? Innervates what?

Back 59

Terminal Branch of inferior alveolar nerve, From Mandibular nerve, of Trigeminal (CN V3); cutaneous innervation to chin

Front 60

Buccal Nerve: branch from? Innervates what?

Back 60

From Mandibular nerve, of Trigeminal (CN V3); cutaneous innervation to skin of lateral face

Front 61

Scalp is moved via contraction of

Back 61

Occipitofrontalis muscle

Front 62

Muscles of external ear

Back 62

anterior, superior & posterior auricularis muscles

Front 63

Smile muscles

Back 63

Zygomaticus minor and major obliquely elevate corners of mouth; risorius acts to pull corner of mouth posteriorly

Front 64

Muscles for Depressing lower lip/corner of mouth mouth

Back 64

--Depressor Labii inferioris and Depressor Anguli Oris depress lower lip and corner of mouth

Front 65

Forms lateral wall of mouth

Back 65

buccinator muscle

Front 66

Sensory innervation of scalp posterior to ear

Back 66

lesser occipital nerve (cervical plexus, C2) and greater occipital nerve (C2 posterior ramus)

Front 67

Sensory innervation of scalp anterior to the ear:

Back 67

Supratrochlear (CN VI), Supraorbital (CN VI) zygomaticotemporal (CN V2) and auricotemporal (CN V3) all branches off Trigeminal (CN V)

Front 68

Infections of scalp are potentially dangerous because:

Back 68

Scalp emissary veins communicate with the venous sinus system of cranium

Front 69

Scalp lacerations bleed profusely due to

Back 69

the extensive anastomotic network of communicating arteries in the scalp

Front 70

The external carotid artery supplies what part of scalp?
Branches?

Back 70

lateral and posterior, via superficial temporal, occipital & posterior auricular a's

Front 71

The internal carotid artery supplies what part of scalp? Branches?

Back 71

Anterior scalp, via supratrochlear & supraorbital arteries

Front 72

Venous drainage of scalp?

Back 72

Supraorbital, supratrochlear, superficial temporal, retromandibular, occipital & posterior auricular veins

Front 73

calvaria

Back 73

skullcap/vault of skull, excluding facial bones; superior portions of frontal, parietal & occipital bones

Front 74

bony elements of TMJ

Back 74

mandibular condyle, mandibular fossa

Front 75

pterygoid fovea

Back 75

depression in ant surface of neck for insertion of lateral pterygoid muscle

Front 76

TMJ: joint type? ligaments? ligament job?

Back 76

synovial, surrounded by synovial membrane;
1)Lateral (tempromandibular ligament): restrains condyles from moving too far post. & damaging soft tissue
2) Sphenomandibular: extends from sphenoid spine to lingula & adj mandible; stabilize TMJ & help avoid extreme movements

Front 77

medial & lateral ends of condyle called

Back 77

poles

Front 78

TMJ articular disk & retrodiskal pad

Back 78

CT tissue peripherally attached to joint capsule; continous post. w/ retrodiskal pad (loose CT & vessels & nerves of TMJ)anteriorly, disk and capsule attached to sup. head of lateral pterygoid

Front 79

Pain in TMJ

Back 79

due to stretching/compression btwn condyle & ant wall of tympanic plate (ext auditory meatus)

Front 80

Very little bone in TMJ suggests?

Back 80

TMJ doesn't act as fulcrum to absorb pressure from chewing: teeth do

Front 81

A blow to one side of mandible could?

Back 81

break the contralateral condylar neck and/or ipsilateral onr

Front 82

'Clicks' in TMJ

Back 82

caused by medial and lateral collateral ligaments that normally force disk to follow condyle in ant & post movements; stretched/torn disks can slip and click as disk slides on/off condyle

Front 83

Jaws Closed position of TMJ

Back 83

condyle & disk rest on post edge of articular eminence (ant wall of mandibular fossa)

Front 84

first 1/3 opening of TMJ

Back 84

rotation of condyle against disk

Front 85

final 1/3 movement in TMJ

Back 85

sliding of condyle & disk down articular eminence in upper chamber: translation

Front 86

middle 1/3 movement in TMJ:

Back 86

combo of
--rotation of condyle against disk in lower chamber
AND
--sliding of condyle & disk down articular eminence (called translation) in upper chamber

Front 87

only direction TMJ can become dislocated

Back 87

anteriroly

Front 88

Major source of innervation to lateral head

Back 88

Cranial Nerve V (Trigeminal); provides general sensory innervation to skin overlying fossae via CNV2 and CNV3

Front 89

Maxillary N & A branches go to?

Back 89

-Orbit
-Nasal cavity & sinuses
-Oral Cavity
-ALL features on anterior head

Front 90

The sphenopalatine ganglion recieves/ gives off fibers from

Back 90

Maxillary Nerve: CN V2
Ganglion gives POSTganglionic PARAsympathetic fibers and receives as well; some pass right thru ganglion, others are joined by PARAsympathetic fibers and ride w/ maxillary nerve branches to target organs

Front 91

Infratemporal Fossa associated w/ what nerves?

Back 91

mandibular div of trigeminal (CNV3)

Front 92

Mandibular nerve innervates what? origins?

Back 92

Mandibular nerve, div of Trigeminal (CN V3);
motor branches to muscles of mastication:
named by muscles supplied

Front 93

Exception: Mandibular Division names

Back 93

Buccal Br of CNV3 is NOT motor to Buccinator muscle; sensory. motor provided by Buccal Nerve, br of Facial

Front 94

Only mandibular branch that passes posteriorly; loops around? supplies?

Back 94

auriculotemporal (CNV3); commonly loops around middle meningeal artery; TMJ

Front 95

Secretomotor fibers of IX have branches from what other CN? supplying?

Back 95

Auriculotemporal nerve, of CNV3 (Mandibular Trigeminal); suppling parotid gland

Front 96

Nerve, sensory, of teeth

Back 96

Inferior Alveolar, from CNV3

Front 97

What gives off br to mylohyoid? supplying?

Back 97

Inferior Alveolar, br from CNV3; supplies mylohyoid & anterior digastric

Front 98

Vidian/Pterygoid Nerve composed of fibers from?

Back 98

combined sym/parsymp nerve from VII's greater petrosal nerve (parasymp) and internal carotid nerve's deep petrosal nerve (symp)

Front 99

Where do fibers of Vidian synapse?

Back 99

Fibers from VII synapse in sphenopalatine ganglion & psotsynaptic fibers travel in branches of maxillary nerve to smooth muscles & glands in anterior head above oral cavity

Front 100

To numb all branches of V3 (mandibular nerve of trigeminal)?

Back 100

needle passed thru mandibular notch to roof of infratemporal fossa

Front 101

numb teeth?

Back 101

anaesthetic injected at lingula of mandible to block inferior alveolar nerve

Front 102

block mental nerve (chin stitch)

Back 102

anasthetic injected into mental foramen

Front 103

cheeck numbing?

Back 103

injection into mucosa, covering retromolar fossa (post to 3rd mandibular molar)

Front 104

Trigeminal neuralgia (tic douloureux)

Back 104

sensory disorder where patient feels paroxysmal pain in regions innervated by maxillary & mandibular br of CNV; due to prescense of anomalous artery compressing root of nerve; alleviated by surgically moving artery

Front 105

Injury to nerve distal to stylomastoid foramen, by parotid bed, or in gland itself?

Back 105

paralyzes muscles of facial expression but NOT autonomic function/special sensation; injury of CNVII in/on parotid results in motor deficits

Front 106

Provides secretomotor innervation to parotid gland?

Back 106

CN IX (Glossopharyngeal) via the auriculotemporal;

Front 107

PREgang. parasym. fibers emerge from inferior ganglion of IX as ? then what?

Back 107

tympanic nerve, turns, enters tympanic canal (btwn jugular foramen & carotid canal) & joins tympanic plexus

Front 108

Describe what happens to nerves in TYMPANIC PLEXUS

Back 108

-PREgang fibers leave as LESSER PETROSAL N., on the hiatus for lesser petrosal n., and enters infratemporal fossa & otic ganglion

Front 109

Describe OTIC GANGLION

Back 109

small PARASYMP ganglion on medial side of mandibular n.; PREgang PARAsymp fibers of LESSER PETROSAL N synapse here; POSTgang fibers pass on to AURICULOTEMPORAL N & confer secretomotor capacity for parotid gland

Front 110

Glands on ANTERIOR HEAD receive ??? and glands of the POSTERIOR HEAD receive???

Back 110

PARAsymp SECRETOMOTOR innervation (PSI) from CNVII (facial); PSI from IX (glossopharyngeal)

Front 111

Order: pathway from IX to parotid gland

Back 111

IX>tympanic nerve>tympanic plexus>otic ganglion>auriculotemporalnerve>parotid gland

Front 112

VII serves anterior head via?then what?

Back 112

Ptergopalatine & submandibular ganglia; ptergopalatine ganglion sends PSI to glands SUPERIOR to oral cavity; Submandibular ganglion sneds PSI to glands INFERIOR to oral cavity

Front 113

Parotid Associated with Several Nerves and Vessels:???

Back 113

--Facial: thru it to emerge as 5 branches
--Auricotemporal Nerve (from CNV), enters after passing around neck of condyle; carries secretomotor impulses
--Greater Auricular Nerve; sensory innervation (from cervical plexus)
--External Carotid Artery; gives off terminal br.s, maxillary & superficial temporal
--Retromandibular Vein: passes thru it, drains post face & infratemporal fossa

Front 114

temporary Bell's palsy can be caused by?

Back 114

passing needle too far during dental procedure; going too far posteriorly at lingula of mandible & enter parotid gland, & get nerves from CNVII

Front 115

Temporal Fossa Boundaries

Back 115

depression encircled by superior & inferior temporal lines
INFERIORLY: extends to infratemporal crest, ridge marking point of contour of bone turning MEDIALLY at a right angle to temporal fossa to become ROOF of INFRATEMPORAL FOSSA

Front 116

INFRATEMPORAL FOSSA

Back 116

caavity w/ icomplete walls, anteriorly bounded by maxilla's post. walls, medially limited by pterygoid plates; ramus of mandible forms lateral boundary; roof formed by greater wing of sphenoid & temporal bone; extends posteriorly to include mandibular fossa ; NO defined post & inferior boundaries

Front 117

PTERYGOMAXILLARY FISSURE

Back 117

roughly triangular opening btwn lat. ptyergoid plate & maxilla; can be probed to find the ptergopalatine/sphenopalatine fossa

Front 118

ptergopalatine/sphenopalatine fossa communicates with?

Back 118

several openings---FIX THIS CARD LATER

Front 119

Contents of INFRATEMPORAL FOSSA

Back 119

lower portion of temporalis m., lateral & medial pterygoid ms., pterygoid plexus of veins, mandibular n & branches, maxillary a. & br.s, chorda tympani, otic ganglion

Front 120

Contents of TEMPORAL FOSSA

Back 120

temporalis m., deep temporal nerves & vessels, the auricotemporal nerve, superificial temporal vessels

Front 121

INTRATEMPORAL FOSSA: boundaries?

Back 121

1) Anterior:post. surface of maxilla
2) Posterior: styloid process
3) Medial: lat.pterygoid plate of sphenoid bone
4) Lateral:ramus & coronoid process of mandible
5)Roof:infratemporal surface of greater wing of sphenoid bone

Front 122

Temporalis muscle

Back 122

Origin: Temporal fossa, temporal fascia
Insertion: Coronoid process and temporal crest of the mandibular ramus
Blood supply: Anterior and posterior deep temporal arteries
Nerve supply: Anterior and posterior deep temporal nerves
Action: Elevation and retraction of the mandible

Front 123

Medial pterygoid

Back 123

Origin: Medial surface of lateral pterygoid plate
Insertion: Medial surface of the ramus of the mandible (below mandibular foramen)
Blood supply: Arterial twigs of the maxillary artery
Nerve supply: Nerve to medial pterygoid
Action: Protraction and elevation of the mandible

Front 124

Masseter muscle

Back 124

Origin: Zygomatic arch
Insertion: Lower half of the mandibular ramus
Blood supply: Masseteric artery
Nerve supply: Masseteric nerve
Action: Mandibular elevation (powerful crusher of food)

Front 125

Lateral pterygoid

Back 125

Origin: Upper head - base of the skull (greater wing of sphenoid); Lower head - lateral surface of lateral pterygoid plate
Insertion: Upper head - capsule and articular disc of the TMJ; Lower head - pterygoid fovea of the condylar neck
Blood supply: Twigs from the maxillary artery
Nerve supply: Short nerves from the mandibular division of the trigeminal nerve
Action: Protraction and opening movements of mandible

Front 126

Mandibular Nerve: Source & Branches

Back 126

Trigeminal ganglion, motor root of CNV from pons;
meningeal br., medial & lateral pterygoid, masseteric, anterior & posterior deep temporal, buccal, auriculotemporal, lingual, inferior alveolar

Front 127

Mandibular Nerve: Motor & Components

Back 127

MOTOR:
mylohyoid, anterior belly of digastric; tensor tympani, tensor veli palatini; muscles of mastication (temporalis, masseter, medial & lateral pterygoid)
SENSORY:
GSA: skin of lower lip & jaw extending superiorly above level of ear; GVA: tongue, & floor of mouth, lower teeth & gingiva

Front 128

AURICULOTEMPORAL NERVE:
source; branches

Back 128

Mandibular div of trigeminal;
parotid brs, articular brs, ant auricular brs

Front 129

Hypoglossal Nerve:AKA; source, branches

Back 129

CNVXII
medulla: hypoglossal nucleus; no branches
(br.s of C1 carried by it ot considered CNVII br.s)

Front 130

Hypoglossal Nerve: supplies? travels?

Back 130

intrinsic & extrinsic muscles of tongue (except palatoglossus m)
--passes thru hypoglossal canal; superior root of ansa cervicalis travels w/ hypoglossal nerves

Front 131

Describe Submandibular Ganglion:
1) Source
2) branches
3) Motor innervations
4) Location

Back 131

1) Source: preganglionic parasympathetic from chorda tympani accompanying lingual n.
2) branches:
postganganglionic parasympathetic to submandibular & sublingual glands
3) Motor innervations:
secretomotor to submandibular & sublingual glands
4) Location
Hangs off lingual n. above deep part of submandibular gland

Front 132

TMJ syndrome:

Back 132

TMJ syndrome: Disorder of the temporo-mandibular joint(s) causing pain usually in front of the ear(s).

Front 133

TMJ Dislocation:

Back 133

TMJ Dislocation: Excessive contraction of the lateral pterygoids may cause the jaw to dislocate anteriorly (pass anterior to the anterior tubercles. This could happen during yawning or when taking a large bite. Also sideway blows to the chin when the mouth is open dislocates the TMJ on the side that receives the blow. TMJ dislocation is frequently accompanied by fracture of the mandible. Posterior dislocation of the TMJ is uncommon due to the resistence by the postglenoid tubercle and the strong intrinsic lateral or temporomandibular ligament. Care must be taken during repair in regards to the facial and the auriculotemporal nerve; injury to the auriculotemporal nerve leads to laxity and instability of the TMJ.

Front 134

intrinsic muscles of the tongue

Back 134

includes the superior and inferior longitudinals, transverse, and vertical muscles

Front 135

1)frenulum of tongue
2)sublingual caruncle

Back 135

1)fold of mucous membrane under tongue (Latin, frenulum = a bridle)
2) papilla on lateral side of frenulum of tongue; opening of the duct of the submandibular gland

Front 136

foramen ovale transmits?

Back 136

transmits mandibular div of trigeminal, accesory meningeal artery, lesser petrosal nerve, recurrent meningeal br of CNV and a vein

Front 137

Pterygoid Fossa transmits? how do these get to the fossa to begin with?

Back 137

the vidian nerve, a conjoining of the greater and deep petrosal nerves;the ptyergoid (vidian) canal at the base of the medial pterygoid carries the vidian nerve (nerve of pterygoid canal) to the fossa;

Front 138

Foramen spinosum transmits?

Back 138

the middle meningeal artery

Front 139

stylomastoid fossa trasmits?

Back 139

end of the facial canal & transmits facial nerve

Front 140

jugular foramen transmits?

Back 140

transmits the internaljugular vein & the CNIX (glossoph) CNX (vagus) and spinal accesory

Front 141

TMJ: elevation/depression

Back 141

lower compartment; as condyle rotates on articular disk;

Front 142

TMJ: Protrusion/Retraction

Back 142

Upper compartment; articular disk glides ant/post along temporal bone between mandibular fossa and articular tubericle

Front 143

Order of TMJ movements

Back 143

When the joint moves, the lower hinge component of the joint moves first, to initiate mandibular opening (articular disk and condyle). The upper part of the joint, between the articular disc and the mandibular fossa and articular eminence of the temporal bone, creates the gliding component. During joint movement, this gliding cavity moves after the hinge component to terminate mandibular opening.